Category: Finding A Surgeon

Primary Care; Radiologist; Breast Surgeon; Oncologist; Plastic Surgeon specializing in mircrosurgery

Breast Reconstruction: Seromas Pre and Post-Operative Assessment

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Breast Reconstruction: Seromas Pre and Post-Operative Assessment Breast reconstruction complications are possible as is the case with any surgery. A possible complication in breast reconstruction is the development of a seroma. Here we look at the pre and post-operative assessment of seromas after autologous or implant-based breast reconstruction. I speak to two ASPS board certified plastic surgeons from PRMA in San Antonio, Dr. Ramon Garza III and Dr. Minas Chrysopoulo. I feel fortunate to share this information with the reader. The video in the blog will give a detailed explanation of pre and post-operative assessment of seromas. You can subscribe to DiepCFoundation YouTube channel after watching the video for a variety of educational topics on breast reconstruction. Dr. Garza begins the discussion by explaining who might be more prone than others to complications such as seromas after breast reconstruction. It is important to point out that their practice at PRMA Continue Reading →

What Do Breast Cancer and BRCA Friends Share in Common?

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I know that Heather Barnard and I share a lot in common! We are both educators. Breast cancer has affected Heather and me. Heather and I have had a mastectomy. Heather and I had breast reconstruction. We both write blogs about our breast reconstruction experience. Finally, and most coincidentally, we had the same plastic surgeon perform our breast reconstruction. What makes our friendship unique? We have never met in person. Heather and I live over 9,000 miles apart. Our shared commonalities, however, have bridged those miles and made us friends. Her Twitter handle says it all, @expattravelmom. She teaches in Singapore and in her off time travels extensively with her husband and three great children. I had my DIEP flap breast reconstruction in December of 2014. Heather had a prophylactic mastectomy with immediate implant breast reconstruction in June of 2015. Dr. Chrysopoulo was our connection. Heather would message me asking Continue Reading →

Nipple Reconstruction after Mastectomy

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I am often asked about the process of nipple reconstruction after mastectomy at the time of breast reconstruction. I am grateful to Drs. Minas Chrysopoulo and Ramon Garza III of PRMA in San Antonio who took time to make the video. It can be viewed from this blog explaining the procedure. My own experience during my DIEP flap breast reconstruction was a skin sparring, nipple sparring mastectomy. My breast surgeon clearly explained how she was going to make every attempt to save my nipples during my mastectomy. She also was very forthright in telling me, based on tumor size and location, she may not be able to save my nipples. I felt fortunate she successfully saved my nipples at the time of my double mastectomy. This is not always the case for every woman or man who has a mastectomy. There are reasons nipples cannot be saved. There are also patients Continue Reading →

Surgical Loupes Used in Breast Reconstruction

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Sometimes we like to have fun at DiepCFoundation. This video about the surgical loupes used in breast reconstruction was one of those moments. Dr. Ramon Garza of PRMA in San Antonio was kind enough to bring his surgical loupes for me to try on. Dr. Minas Chrysopoulo, his team member at PRMA, looked on with amusement when I tried to focus while maneuvering my hands to appreciate the magnification. What I noticed most was adjusting to the depth perception while I had the surgical loupes on. Dr. Garza verified it takes a lot of training and hours spent in the operating room learning how to use the surgical loupes and the technical aspects of the surgery. He states the following: Good optics allow micro-surgeons to do what they do. The surgical loupes help to see very tiny, delicate structures. Function always overrides form in microsurgical breast reconstruction. The surgical loupes help Continue Reading →

Aesthetic Questions to Ask If Going Flat After Mastectomy

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Have you decided to go flat after having a mastectomy? This blog and video discuss aesthetic questions to ask if going flat after mastectomy. When a woman or man loses their breast to breast cancer they have choices whether to rebuild their breast or not. They can choose to go flat, or they can choose breast reconstruction. I had a mastectomy in May of 2014 and remained flat for seven months prior to having DIEP flap breast reconstruction. But there are many women and men who choose to remain flat after a mastectomy. I had the privilege of speaking to Drs. Minas Chrysopoulo of PRMA in San Antonio about this topic. They are both plastic surgeons who perform various kinds of plastic surgery, primarily autologous based breast reconstruction. The information they explain in this video and have personally done themselves, is achieving optimal aesthetic outcomes for patients who choose to Continue Reading →

ERAS Protocol Breast Reconstruction

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A little over a year ago I learned about ERAS protocol as it pertains to breast reconstruction from the plastic surgeon who performed my DIEP flap. ERAS, Enhanced Recovery after Surgery, protocol was not in place at the time I had breast reconstruction in December of 2014.  I wrote a blog about our conversation and what I learned. I have been reading several social media posts about ERAS and the benefits to patients. One study shared recently on Twitter states in the conclusion of the study: Conclusion: Enhanced recovery pathway program implementation should be considered as the standard approach for perioperative care in autologous tissue-based breast reconstruction because it does not affect morbidity and is associated with accelerated recovery with reduced postoperative opiate use and decreased length of hospital stay, leading to downstream health care cost savings.  ~ Journal of the American Society of Plastic Surgeons ERAS Protocol Benefits Observed I Continue Reading →

The Value of a 2nd Opinion for Breast Reconstruction

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The value of a 2nd opinion for breast reconstruction is fortunately something that has the potential to give women hope if they have been turned down at an initial consult for autologous breast reconstruction. I had the fortune to talk with two board certified microsurgeons, Dr. David Song of MedStar Georgetown and Dr. Minas Chrysopoulo of PRMA in San Antonio. Both plastic surgeons successfully and routinely perform a variety of autologous flap surgeries with great success. What is autologous breast reconstruction? Autologous breast reconstruction is using another area of the patient’s body using the tissue and underlying blood vessels to create a soft, warm, new breast after a mastectomy. Why are women sometimes turned down by plastic surgeons or told they are not good candidates for autologous breast reconstruction? Here are some of the reasons Dr. Song and Dr. Chrysopoulo mention in the video: Well trained colleagues in plastic surgery Continue Reading →

Patient Advocacy: Shared Decision Making in Breast Reconstruction

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When does your voice matter in patient advocacy in the shared decision-making conversation of breast reconstruction? The sum of events helps me answer this question in my work as a patient advocate. I have a voice, true. However, my voice only becomes amplified by the support, connections, and personal interaction I make through social media with those interested in this topic; plastic surgeons and patients who have lived the experience. Shared decision making in breast reconstruction after mastectomy means a process the patient and plastic surgeon engage in, resulting in the choice the patient believes is in their best interest. It includes but is not limited to the suggestions made by the plastic surgeon based on skill and years of expertise, being given all options for breast reconstruction, discussing risks and complications, and listening to and respecting the voice of the patient and what they bring to the conversation. This Continue Reading →

Waiting for Authorization for Breast Reconstruction

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Waiting for Authorization for Breast Reconstruction It can take enormous patience for breast cancer patients who are waiting for authorization for their breast reconstruction procedure. I was once there. Now I am an advocate for all options of breast reconstruction after mastectomy. I interact with patients daily. Many times, their questions are a catalyst for topics to write a blog. Amplifying our voices to educate is part of patient advocacy responsibility. I recently received an email from a patient who was denied coverage for a revision phase of her reconstruction. Her plastic surgeon even wrote an appeal, but it was still denied. She reached out to me for help and suggestions about what to do. I take a deep breath when I get these emails and step out of my breast cancer survivor role and put on my patient advocate hat. I don’t want to offer false hope, but I Continue Reading →

Sensory Nerve Reconstruction During DIEP Flap after a Mastectomy

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DiepCFoundation interviews Dr. Minas Chrysopoulo from PRMA in San Antonio about sensory nerve reconstruction during DIEP flap after mastectomy to restore sensation to the breasts. The procedure is called microneurorrhaphy (micro-ner-ar-o-fee) A real mouth full! Dr. C points out that this is a complex topic to describe at a consult. A plastic surgeon may say that your breasts will “feel” more natural but “to whom”? The reality is that the patient will not feel the same that they did before mastectomy. I am the Founder and Director of DiepCFoundation and was fortunate to have this interview with Dr. Chrysopoulo. I am also a patient who has had successful sensory nerve repair performed by Dr. C. It is truly better than the alternative, which is NO sensation in the breasts at all. I’m quite used to this “new” sensation now and I like it. I feel very fortunate to have found Continue Reading →